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J Korean Soc Emerg Med > Volume 27(4); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(4): 345-350.
변형된 피하일회주입 손가락 신경차단술의 마취효과
이영규1, 이지숙2, 김경환1, 박준석1, 신동운1, 김현종1, 박준민1, 김훈1, 전우찬1
1인제대학교 일산백병원 응급의학과
2아주대학교 의과대학 응급의학교실
The Anesthetic Effect of Modified Subcutaneous Single-Injection Digital Block
Youngkyu Lee1, Jisook Lee2, Kyung Hwan Kim1, Junseok Park1, Dongwun Shin1, Hyunjong Kim1, Joon Min Park1, Hoon Kim1, Woochan Jeon1
1Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
2Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
Correspondence  Woochan Jeon ,Tel: 031-910-9781, Fax: 031-910-7188, Email: woowoochan@gmail.com,
Received: April 23, 2016; Revised: April 25, 2016   Accepted: June 27, 2016.  Published online: August 31, 2016.
ABSTRACT
Purpose:
The aim of this study is to investigate the anesthetic effect on a modified subcutaneous single-injection digital block in accordance with the location of the finger.
Method:
We recruited volunteers from the workshop training course. We injected less than 5 mL of 2% lidocaine at the volar side, between the 3rd metacarpal and proximal phalangeal joint, until the swelling in the dorsal side of the finger increased. At 10 minutes post the modified subcutaneous single-injection digital block, we recorded the pain score (0-10) using 11-point numeric rating pain scale (NRPS) according to the location of the finger (volar proximal phalanx, VPP; volar middle phalanx, VMP; volar distal phalanx, VDP; dorsal distal phalanx, DDP; dorsal middle phalanx, DMP; dorsal proximal phalanx, DPP) via a pinprick test. We analyzed and compared the NRPS on the location of the finger by the Friedman test with a Pairwise comparison.
Results:
Fifty-eight volunteers of healthy adult were enrolled in this study. The pain scales on DPP and DMP were 7.00 (4.00-8.00) and 2.00 (1.00-4.00), respectively. The pain scales on DDP, VDP, VMP and VDP were 0.00 (0.00-2.00), 0.00 (0.00-0.00), 0.00 (0.00-1.00) and 0.00 (0.00-1.00), respectively. The pain scales on DPP and DMP were significantly different among DDP, VPP, VMP and VPP (p<0.05). There were no significant differences of pain scale on DDP, VDP, VMP and VPP (DDP vs. VDP, p=0.592; DDP vs. VMP, p=0.749; DDP vs. VPP, p>0.999; VDP vs. VMP, p>0.999; VMP vs. VPP, >0.999).
Conclusion:
A modified subcutaneous single-injection digital block should be considered useful in regional anesthesia at the volar side of the finger and the dorsal side of the distal phalanx.
Key words: Finger injuries, Local anesthesia, Nerve block, Pain measurement, Subcutaneous injections
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